2010 年至 2019 年性传播感染发病率上升：基于 2019 年全球疾病负担研究的地理区域和年龄组时间趋势分析。
Increasing incidence rates of sexually transmitted infections from 2010 to 2019: an analysis of temporal trends by geographical regions and age groups from the 2019 Global Burden of Disease Study.
机构信息
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Institute for Global Health and Development, Peking University, Beijing, 100871, China.
出版信息
BMC Infect Dis. 2022 Jun 26;22(1):574. doi: 10.1186/s12879-022-07544-7.
BACKGROUND
World Health Organization announced its goal of ending sexually transmitted infection (STI) epidemics by 2030. To provide a reference for tailored prevention strategies, we analyzed trends and differences in STIs by geographical regions and age groups from 1990 to 2019.
METHODS
Annual number of new infections and age-standardized incidence rates (ASRs) of syphilis, chlamydia, gonorrhea, trichomoniasis, and genital herpes were recorded from the 2019 Global Burden of Disease study. We quantified the temporal trends of STIs by calculating changes in new infections and estimated annual percentage changes (EAPCs) of ASR.
RESULTS
The ASRs of syphilis, chlamydia, trichomoniasis, and genital herpes increased by 1.70% (95% confidence interval [CI], 1.62-1.78%), 0.29% (95% CI 0.04-0.54%), 0.27% (95% CI 0.03-0.52%), and 0.40% (95% CI 0.36-0.44%) per year from 2010 to 2019 worldwide, respectively, while that of gonorrhea did not. The American regions had the greatest increase in ASR for syphilis (tropical Latin America: EAPC, 5.72; 95% CI 5.11-6.33), chlamydia (high-income North America: EAPC, 1.23; 95% CI 0.73-1.73), and gonorrhea (high-income North America: EAPC, 0.77; 95% CI 0.12-1.41). Additionally, southern sub-Saharan Africa and East Asia had the greatest increase in ASR for trichomoniasis (EAPC, 0.88; 95% CI 0.57-1.20) and genital herpes (EAPC, 1.44; 95% CI 0.83-2.06), respectively. In the most recent years, the population with the greatest incidence of syphilis tended to be younger globally (25-29 years in 2010 vs. 20-24 years in 2019) but older in North Africa and Middle East (20-24 year vs. 25-29 years); with chlamydia tended to be older in southern sub-Saharan Africa (25-29 years vs. 30-34 years) but younger in Australasia (40-44 years vs. 25-29 years); with genital herpes tended to be older in high-income North America (20-24 years vs. 25-29 years) and South Asia (25-29 years vs. 30-34 years).
CONCLUSIONS
Syphilis, chlamydia, trichomoniasis, and genital herpes showed a trend of increasing ASR from 2010 to 2019. The differences in trends by geographical regions and age groups point to the need for more targeted prevention strategies in key regions and populations.
背景
世界卫生组织宣布其目标是到 2030 年结束性传播感染（STI）的流行。为了提供定制预防策略的参考，我们分析了 1990 年至 2019 年按地理位置和年龄组划分的 STI 趋势和差异。
方法
2019 年全球疾病负担研究记录了梅毒、衣原体、淋病、滴虫病和生殖器疱疹的新感染人数和年龄标准化发病率（ASR）。我们通过计算新感染人数的变化来量化 STI 的时间趋势，并估计了 ASR 的年百分比变化（EAPC）。
结果
2010 年至 2019 年，全球梅毒、衣原体、滴虫病和生殖器疱疹的 ASR 分别以每年 1.70%（95%置信区间[CI]，1.62-1.78%）、0.29%（95%CI 0.04-0.54%）、0.27%（95%CI 0.03-0.52%）和 0.40%（95%CI 0.36-0.44%）的速度增长，而淋病则没有。美洲地区梅毒（热带拉丁美洲：EAPC，5.72；95%CI 5.11-6.33）、衣原体（高收入北美：EAPC，1.23；95%CI 0.73-1.73）和淋病（高收入北美：EAPC，0.77；95%CI 0.12-1.41）的 ASR 增幅最大。此外，南部撒哈拉以南非洲和东亚的滴虫病（EAPC，0.88；95%CI 0.57-1.20）和生殖器疱疹（EAPC，1.44；95%CI 0.83-2.06）的 ASR 增幅最大。在最近几年，全球梅毒的发病高峰人群趋于年轻化（2010 年为 25-29 岁，而 2019 年为 20-24 岁），但在北非和中东地区则更为年长（20-24 岁）；衣原体在南部撒哈拉以南非洲地区的发病高峰人群更为年长（25-29 岁），而在澳大拉西亚地区则更为年轻（40-44 岁）；生殖器疱疹在高收入北美地区（20-24 岁）和南亚地区（25-29 岁）的发病高峰人群更为年长。
结论
梅毒、衣原体、滴虫病和生殖器疱疹的 ASR 从 2010 年至 2019 年呈上升趋势。地理位置和年龄组的趋势差异表明，需要在关键地区和人群中制定更有针对性的预防策略。
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